Pharmacology Flashcards by Imogen Smedley

What class do the neurotransmitters NA and seritonin 5-HT belong to?

monoamines

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Noradrenaline pathways in the brain are widely distributed. T or F

true

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Where do the NA pathways of the brain originate?

brainstem

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What primitive features does NA have a role in?

arousal and emotion

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Serotonin pathways are widely distributed through the cortexes and subcortical areas. T or F

true

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Where do the serotonin 5-HT pathways of the brain originate?

brainstem

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Serotonin 5-HT has a role in mood, sleep, feed, behaviour, sensory perception and analgesia. T or F

true

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What non psychiatric disorder can antidepressants be prescribed for?

neuropathic pain

migraine

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What is the 1st line antidepressant?

there isn’t one. match to patient’s needs - but generally its a SSRI

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Give examples of MAOIs monoamine oxidase inhibitors?

phenelzine, moclobemide

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Typical antidepressants act at the _____ and include the classes _____, ______, _____ and ______. Atypical antidepressants act at the ______.

Typical antidepressants act at the synapse and include the classes MAOIs, SSRIs, SNRIs and tricyclics. Atypical antidepressants act post-synaptically.

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What must you be mindful of when prescribing MAOIs and why?

PTx cannot eat foods containing tyramine (cheese, venison, red wine etc.) since can cause hypertensive crisis

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How would a hypertensive crisis due to eating tyramine when taking MAOIs present?

headache
SOB
nosebleed

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Give examples of MAOI SEs

insomnia
postural hypotension
peripheral edema

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What is the mechanism of tricyclics?

non-selectively inhibit monoamine reuptake

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Give examples of tricyclic antidepressants

amitriptyline
dosulepin
imipramine
lofepramine

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What are the contraindications to tricyclics?

elderly / cognitive impairment

suicidal intent - is this true?

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Can you overdose on tricyclics?

yes - OD is cardiotoxic

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What are some side effects of tricyclic antidepressants

anticholinergic SEs
sedation
weight gain
arrhythmia
postural hypotension

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Give examples of anticholinergic side effects

blurred vision
constipation
dry mouth
urinary retention
sweating

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What is the mechanism of SSRIs?

inhibit serotonin 5-HT reuptake at synaptic cleft to increase extracellular 5-HT conc

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Can you OD on SSRIs?

SSRIs have no OD risk

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Give examples of SSRIs

fluoxetine
citalopram
paroxetine
escitalopram
sertraline

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What are the side effects of SSRIs

nausea
HA
sweat
vivid dream
anxiety/agitation
sex

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Give examples of SNRIs

venlafaxine, duloxetine

What is the mechanism of SNRIs

non-selectively block reuptake to presynaptic terminal

What are the side effects of SNRIs

Same as SSRIs but more likely

What drug class are reboxetine and maprotiline in?

antidepressants - NA reuptake inhibitor

What receptor does agomelatine act on?

melatonin receptors

What is the mechanism of mirtazapine?

blocks alpha-2 & 5-HT receptors post-synaptically

What are the side effects of mirtazapine?

weight gain | sedation (hence good for insomnia)

Buproprion is an atypical antidepressant. Its mechanism is a ____ uptake inhibitor

dopamine uptake inhibitor

Which mood stabiliser blocks the phosphatidylinositol pathway or inhibits glycogen synthase kinase 3β?

lithium

Lithium has a ____ therapeutic index

narrow

Does lithium cause weight gain or weight loss?

weight gain

What should you monitor when prescribing lithium?

U+E, TFT, ECG

Side effects of lithium?

``` dry mouth strange taste polydipsia/uria tremor hypothyroid renal nephrogenic DI ```

How does lithium toxicity present?

V, diarrhea, coarse ataxic tremor, drowsy, convulsion, coma

What is the general mechanism of typical antipsychotics?

block D2 receptors in nigrostriatum

Give examples of typical antipsychotics

Haloperidol, chlorpromazine, thioridazine, fluphenazine

What side effect of typical antipsychotics can take years to present?

tardrive dyskinesia (orofacial)

What hormone disturbance can occur as a side effect of typical antipsychotics and how would this present?

>PRL | gynaecomastia, galactorrhea, ED,

What side effect of typical antipsychotic occurs soon after beginning the drug, and is managed with anticholinergics?

acute dystonic reaction

What side effect of typical antipsychotics is managed by decreasing the dose or adding an anti-acetylcholinesterase?

Parkinsonism extra-pyramidal

Typical antipsychotics cause sedation. T or F

true

Are typical or atypical antipsychotics better for the negative symptoms of schizophrenia?

atypical

Give examples of atypical antipsychotics

quetiapine, clozapine, olanzapine, risperidone, aripiprazole, olanzapine

Atypical antipsychotics block histamine that leads to which side effects?

sedation | increased appetite/wt

Atypical antipsychotics block Na that leads to which side effects?

postural hypotension

What is one of the main side effects from atypical antipsychotics?

metabolic synd

What is the most effective antipsychotic drug?

clozapine

What are the side effects of clozapine?

agranulocytosis >saliva myocarditis weight gain

How do you monitor clozapine to prevent agranulocytosis

FBC once a week for 6 months. then every 2 weeks

Which anticonvulsants can be used as antipsychotics?

valproate lamotrigine carbamazepine

What are the side effects of lamotrigine?

SJS stevent johnson synd | diarrhoea/vomiting

What are the side effects of carbamazepine?

drowsy, ataxic, CVD, induces liver enzymes

What is the mechanism of valproate?

>GABA

What are contraindications to valproate?

female of child-bearing age since neural tube defect teratogen

Name 5 types of anxiolytics

``` benzos pregabalin beta-blockers buspirone barbituates ```

What is the general mechanism of benzos?

>GABA inhibition at GABA-A receptor

Do benzos have a rapid or slow onset?

rapid onset

Can you overdose on benzos?

What effect do benzos have on muscle?

relaxation

Name 3 examples of benzos?

lorazepam diazepam (valium) chlordiazepoxide

Do benzos increase or decrease aggression?

decrease

Are benzos sedative?

yes

What effect do benzos have on depression?

worsen it

Benzos can cause psychosis, >HR, tremor, convulsion, sweat, confuse and agitation by what mechanism?

rapid withdrawal

What is the mechanism of pregabalin?

Ca2+ channel blocker, >GABA

Propanolol can be prescribed for ____ anxiety symptoms such as _____ and ____, in the _____ age range.

Propanolol can be prescribed for somatic anxiety symptoms such as palpitation and tremor, in the adult age range.

If a PTx taking an SSRI and experiences a loss of libido, what medication can you co-administer to prevent this?

buspirone

Pharmacology Flashcards

(71 cards)